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The Study on the Medical and Nursing Service Needs of the Terminal Cancer Patients and Their Caregivers (말기암 환자와 가족의 의료 및 간호 서비스 요구)

  • 이소우;이은옥;허대석;노국희;김현숙;김선례;김성자;김정희;이경옥
    • Journal of Korean Academy of Nursing
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    • v.28 no.4
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    • pp.958-969
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    • 1998
  • In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining them based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC/sup +/ program. The results of this study are summarized as follows ; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue (80.6%). 2) Main therapies for the terminal cancer patients were pain control (58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device (11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patients. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. Also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) Caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.

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The Perception of Aseptic Foods in Cancer Patients (멸균식 개발에 대한 암환자의 인식조사)

  • Lee, Kyung-A;Son, Eun-Joo;Song, Beom-Seok;Kim, Jae-Hun;Lee, Ju-Woon;Lyu, Eun-Soon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.2
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    • pp.203-211
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    • 2013
  • The purpose of this study was to investigate the perception of aseptic foods (sterilized foods with radiation technology) in cancer patients in Busan. The subjects were 192 cancer patients at a hospital. This study was performed through interviews using questionnaires. Patients had perception scores on the need to develop aseptic foods (4.30 points out of 5.00), use aspetic foods (4.06/5.00), and intake aseptic foods (4.04/5.00). Patients less than 59 years old had significantly higher perception scores than those over 60 years old (p<0.05). The scores on aseptic food indicated the importance of various factors, including sanitation (4.86/5.00), good materials (4.82/5.00), nutritional value (4.79/5.00), unused of monosodium glutamate (MSG) (4.66/5.00), taste (4.61/5.00), and reasonable prices (4.60/5.00). The patients who were college graduates showed significantly higher scores and importance in good materials, proper packaging unit, simple cooking methods, food diversity, and familiar foods (p<0.05). In the aseptic menu items, patients wanted to include seasoned raw vegetables (4.11/5.00), a set menu (including cooked grain, soup, and a side dish) (4.08/5.00), seasoned cooked vegetables (4.04/5.00), low sodium kimchi (3.98/5.00), and fermented sauces (3.92/5.00). The patients with gastrointestinal cancer and other cancers (e.g. breast, thyroid, and renal cancer) had significantly higher necessity scores than lung patients for stew, seasoned raw vegetables, salad, low sodium kimchi, and a set menu (p<0.05).

Optimal Spatial Scale for Land Use Change Modelling : A Case Study in a Savanna Landscape in Northern Ghana (지표피복변화 연구에서 최적의 공간스케일의 문제 : 가나 북부지역의 사바나 지역을 사례로)

  • Nick van de Giesen;Paul L. G. Vlek;Park Soo Jin
    • Journal of the Korean Geographical Society
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    • v.40 no.2 s.107
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    • pp.221-241
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    • 2005
  • Land Use and Land Cover Changes (LUCC) occur over a wide range of space and time scales, and involve complex natural, socio-economic, and institutional processes. Therefore, modelling and predicting LUCC demands an understanding of how various measured properties behave when considered at different scales. Understanding spatial and temporal variability of driving forces and constraints on LUCC is central to understanding the scaling issues. This paper aims to 1) assess the heterogeneity of land cover change processes over the landscape in northern Ghana, where intensification of agricultural activities has been the dominant land cover change process during the past 15 years, 2) characterise dominant land cover change mechanisms for various spatial scales, and 3) identify the optimal spatial scale for LUCC modelling in a savanna landscape. A multivariate statistical method was first applied to identify land cover change intensity (LCCI), using four time-sequenced NDVI images derived from LANDSAT scenes. Three proxy land use change predictors: distance from roads, distance from surface water bodies, and a terrain characterisation index, were regressed against the LCCI using a multi-scale hierarchical adaptive model to identify scale dependency and spatial heterogeneity of LUCC processes. High spatial associations between the LCCI and land use change predictors were mostly limited to moving windows smaller than 10$\times$10km. With increasing window size, LUCC processes within the window tend to be too diverse to establish clear trends, because changes in one part of the window are compensated elsewhere. This results in a reduced correlation between LCCI and land use change predictors at a coarser spatial extent. The spatial coverage of 5-l0km is incidentally equivalent to a village or community area in the study region. In order to reduce spatial variability of land use change processes for regional or national level LUCC modelling, we suggest that the village level is the optimal spatial investigation unit in this savanna landscape.

A Study on Organizational Effectiveness of Administrative Personnel in Hospitals (병원 행정직원의 조직효과성 수준)

  • Lee, Duk-Gu;Park, Eun-Cheol;Yu, Seung-Hum;Sohn, Tae-Yong
    • Korea Journal of Hospital Management
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    • v.7 no.2
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    • pp.52-79
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    • 2002
  • The hospital is characterized by it's remarkable labor industry and human resources input by unit. Recently, the administrative personnel are recognized as an important staff to provide a hospital guidance to consumer and also easiness for consumer's visit to hospital. The purpose of this study is to find the organizational effectiveness of the administrative personnel in hospitals. The survey data involved in the study was derived from 229 personnels working in 3 medium and small sized hospitals and 1 university hospital in Inchon area. The major finding are as follows; 1. The organizational efficiency in accordance with the general characteristics of subjects in order of over 31 years of age, university graduates, long-term tenure and high position is higher, whereas, in as much as wage and well trained personnels in are higher, general hospital's organizational efficiency is higher in comparison with those of university hospital. 2. The organizational efficiency in accordance with satisfaction and the psychological motive contributional factors is higher as much as the high satisfactory level in every hospitals in general. 3. The organizational efficiency in accordance with the factors of job characteristics is higher in as much as difficulty of the jobs is lesser, however there was not statically significance. In as much as job standard level is higher and the more job responsibility the higher organizational efficiency. It was obvious that the higher professional expertise as well as the training and application level are improving the organizational efficiency. 4. The organizational efficiency in accordance with the factors of structural characteristics was higher in as much as the intercommunication was smooth and the structural formalization level are higher, however there was not statically significance between the participation level of decision making and the organizational efficiency. 5. In as much as older age, management of organization and the job level are satisfied, the higher structural formalization level, the smooth intercommunication have affected as major influence factors of organizational efficiency. 6. In the university hospitals is satisfied in the management and job level of hospital organization as there are no difficult jobs while the level of hospital's organizational formality is high and the intercommunication is smooth, which are improving the organizational efficiency. In the general hospitals is also satisfied the management and job level of hospital organization and psychological motive contributional factors is higher, it was apparent that the organizational efficiency is higher in as much as the level of job standardization is high and the intercommunication is smooth. As a result of this study, in order for improving the organizational efficiency of administrative personnel in hospitals, the management and job level as well as personal relation are preferably satisfied, whereas formalization of organization, intercommunication and etc. should be satisfied, and, therefore, it is advisable to buildup discriminated organizational management and environment for different division on the basis above factors. Since this study is carried on four hospitals in Inchon area, there is a certain limit to generalize its result to all domestic hospitals, nevertheless the gallop poll was made by developing the questionnaires with reasonability and reliability. Especially. as the study was carried by analyzing the comparison of influence factors' difference of organizational efficiency in accordance with the divisional characteristics of the university and general hospitals.

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An Analysis of the High School 'Common Science' Contents and Textbooks (고등학교 ‘공통과학’의 교과내용 및 교과서 분석)

  • Lee, Gwang-Ho;Choi, Jong-Bum;Park, Moon-Kook;Cho, Kyu-Seong
    • Journal of the Korean earth science society
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    • v.18 no.6
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    • pp.453-463
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    • 1997
  • The contents of high school 'Common science' textbooks was analyzed qualitatively and quantitatively. Seven common science textbooks were selected and its contents, structure, inquiry, activities, appendix and its characteristics were investigated, and analyzed using the Goal Clusters of Project Synthesis and Romey's indices of text evaluation were calculated. The contents of each unit are not much different among textbooks because they are written according to the curriculum ordinance and textbook guidelines of the Ministry of Education. The textbooks was consist of $471{\sim}519$ pages. It was distribute similarly among the chapter of 'materials', 'forces', lives' and 'earth'. The chapter of 'energy' and 'environment' was treat significantly. The contents and structure of common science is a mere physical consolidation. I make an alternative plan that a topic form. Inquiry activities used in the textbooks are 11 type, however most of that is interpretation of data, experiment, survey and discussion. Ninety six percents of the experiment, belong to the 1st level, four percents of that belong to the 2nd level of the Schwab's inquiry level and there are no activities of the 3rd level. Little attention is given to Goal Cluster I, II, IV in the common science textbooks currently employed. Its content should be broadened to include all Goal Clusters of Project Synthesis. Homey's indices representing the degrees of student involvement. are $0.57{\sim}1.14$ for sentence analysis, $0.60{\sim}1.67$ for figure and diagram analysis, $0.67{\sim}1.50$ for analysis of questions at chapter ends, respectively, student activity per page investigated being $0.6{\sim}0.9$. But chapter summaries cease to repeats the conclusions of the chapter also it be rather formally and inattentively written.

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The Effects of Science Question Enhancement Instruction on the Science Question Level and Achievement of Middle School Students (질문 강화 수업이 중학생들의 질문 수준과 학업 성취도에 미치는 영향)

  • Chung, Young-Lan;Bae, Jae-Hee
    • Journal of The Korean Association For Science Education
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    • v.22 no.4
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    • pp.872-881
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    • 2002
  • Student questioning is included in the priority of science literacy, to enable students to solve problems by exploring questions, communicating and constructing knowledge(AAAS, 1989). Also, the essence of student questioning in science lies in its function as a link between thinking and learning. But educators did not pay much attention to students' questioning in Korea. The purpose of this study was to investigate the effects of science question enhancement instruction on students' science questioning level and achievement. Also, this study showed the effects of other variables(logical thinking, science achievement, interest, and gender) on students' science questioning level. The pretest-posttest control group design group design was used. The sample was consisted of 80 second grade middle school students in experimental group(Science question enhancement instruction) and 74 students in control group(Traditional learning). Students in both groups were received identical content instruction on the unit 'Structures and functions of plant'. These groups were treated for 15 hours during 6 weeks. Students' questions were rated using the four levels described by the Middle School Students' Science Question Rating Scale(r= .96,)(Cuccio-Schirripa & Steinner, 2000). Science achievement data were collected using a 17 item multiple choice test(Cronbach ${\alpha}$= .84). To investigate students' logical thinking ability, a abridged GALT(Cronbach ${\alpha}$= .69) was used. Five-way ANOVA, ANCOVA, and multiple regression analysis were used to analyze the results. The results indicated that students who received instruction on researchable questioning outperformed those students who were not instructed on high-order questioning(p< .01). Results of correlations indicated that instruction(r= .640), science achievement(r= .311) and logical thinking ability(r= .212) was significantly and positively related with students' questioning level. But, interest and gender did not show any significant correlation with students' questioning level. Science question enhancement instruction was more effective on science achievement than the traditional instruction(p< .01).

Radiation Exposure on Radiation Workers of Nuclear Power Plants in Korea : 2009-2013 (국내 원전 종사자의 방사선량 : 2009-2013)

  • Lim, Young-khi
    • Journal of Radiation Protection and Research
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    • v.40 no.3
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    • pp.162-167
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    • 2015
  • Although the perfomance indicators of the nuclear power plants in Korea show optimal, it requires detailed analysis and discussion centered on the radiation dose. As analysis methods, analysis on the radiation dose of nuclear power plants over the past five years was assessed by comparing the relevant radiation dose of radiation workers and per capita average annual radiation dose of the world's major nuclear power stations was also analyzed. The radiation workers over the annual radiation dose limit of 50 mSv were not. The contrast ratio of the radiation exposure according to the reactor type was the normal operation of PHWR was 6.2% higher than those of the PWR. This shows the radiation work of PHWR during normal driving operation is much more than those of PWR. According to the Performance Indicators of the World Association of Nuclear Operator, the annual radiation dose per unit in 2013 showed 527 man-mSv of Korea is the best country among the major nuclear power generating states, the world average was 725 man-mSv. The annual per capita radiation dose is about 80% less than 1 mSv of the public dose limit and also the average per capita dose showed a very low level as 0.82 mSv. Workers in related organizations showed 1.07 mSv, the non-destructive inspection agency workers showed 3.87 mSv. The remarkable results were due to radiation reduced program such as development of radiation shielding and radiation protection. In conclusion, the radiation exposured dose of nuclear power plants workers in Korea showed a trend which is ideally reduced. But more are expected to be difficul and the psychological insecurity against the operation of the nuclear power plants is existed to the residents near the nuclear power plants. So the radiation dose reduction policy and radiation dose follow up study of nuclear power plants will be continously excuted.

The Effect of Steroid Therapy in Patients with Late ARDS (후기 급성호흡곤란증후군환자에서 스테로이드의 사용 효과)

  • Huh, Jin Won;Lim, Chae-Man;Jegal, Yang-Jin;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Koh, Youn Suck
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.4
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    • pp.376-384
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    • 2002
  • Background : The mortality from acute respiratory distress syndrome(ARDS) in the late stage, which is characterized by progressive pulmonary fibroproliferation, is ${\geq}80%$. Although previous prospective trials failed to show a survival benefit of steroid therapy in early ARDS, recently, a few of reports have described the survival benefit of the long-term use of steroid in patients with late ARDS. In this study, we analyzed the effect of steroid therapy on patients with late ARDS retrospectively in a single. Medral intensive care unit (MICU). Methods : Over a 3-year period, the medical records of 48 ARDS patients who had been on mechanical ventilation more than 8 days were reviewed. 14 patients were treated by the long-term use of methylprednisolone and another 34 patients served as a control. Both groups were comparable regarding clinical and physiologic data lung injury score(LIS), multiple organ failure score, APACHE III and SAPS II score. Because steroid was instituted after 8 days of advanced mechanical ventilatory support in average, we arbitrarily defined the $8^{th}$ day of ARDS as first day of the study. Results : Initially, the groups had similar PF($PaO_2/FiO_2$) ratio, LIS, APACHE III and SAPS II score. By 7th day after the start of steroid therapy, there were significant improvements in PF ratio, LIS, APACHE III and SAPS II score. The mortality in the steroid treated group was significantly lower(42.9% vs 73.5%, p<0.05). Conclusion : Although the data of this study was retrospective and was not randomized, in order to improve the patient's outcomes, steroid therapy should be considered in late ARDS patients. However, prospective trials are needed to define the indication and the effect of steroid therapy in late ARDS.

Evaluation of Image Quality & Absorbed Dose using MCNPX Simulation in the Digital Radiography System (디지털방사선영상시스템에서 MCNPX 시뮬레이션을 이용한 영상 품질 및 선량평가)

  • An, Hyeon;Lee, Dongyeon;Ko, Sungjin;Kim, Changsoo
    • Journal of the Korean Society of Radiology
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    • v.10 no.5
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    • pp.327-335
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    • 2016
  • The study is enforce to study image quality evaluation of condition provide the IEC and combination of clinical conditions each quality of radiation that image quality to assess the conditions provided to IEC in the clinical environment to conduct image quality assessment of the digital radiography system in the detector have environmental limits. First, image quality evaluation was evaluated by measuring the MTF, NPS using four quality of radiation and Using MCNPX simulation lastly DQE make a image quality evaluation after calculating the particle fluence to analyze spectrum quality of radiation. Second, Using MCNPX simulation of four quality of radiation was evaluated absorbed dose rate about electronic 1 per unit air, water, muscle, bone by using Radiation flux density and energy, mass-energy absorption coefficient of matter. Results of evaluation of image quality, MTF of four quality of radiation was satisfied diagnosis frequency domain 1.0 ~ 3.0 lp/mm of general X-ray that indicated 1.13 ~ 2.91 lp/mm spatial frequency. The NPS has added filter, spatial frequency 0.5 lp/mm at standard NPS showed a tendency to decrease after increase. Unused added filter, spatial frequency 0.5 lp/mm at standard NPS showed a certain NPS result value after decrease. DQE in 70 kVp / unuesd added filter(21 mm Al) / SID 150 cm that patial frequency 1.5 lp/mm at standard showed a tendency to decrease after certain value showed. Patial frequency in the rest quality of radiation was showed a tendency to decrease after increase. Results of evaluation of absorbed dose, air < water < muscle < bone in the order showed a tendency to increase. Based on the results of this study provide to basic data that present for the image quality evaluation method of a digital radiation imaging system in various the clinical condition.

A Study on EC Acceptance of Virtual Community Users (가상 공동체 사용자의 전자상거래 수용에 대한 연구)

  • Lee, Hyoung-Yong;Ahn, Hyun-Chul
    • Asia pacific journal of information systems
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    • v.19 no.1
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    • pp.147-165
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    • 2009
  • Virtual community(VC) will increasingly be organized as commercial enterprises, with the objective of earning an attractive financial return by providing members with valuable resources and environment. For example, Cyworld.com in Korea uses several community services to enable customers of Cyworld to take control of their own value as potential purchasers of products and services. Although initial adoption is important for online network service success, it does not necessarily result in the desired managerial performance unless the initial usage is continuously related to the continuous usage and purchase. Particularly, the customer who receives relevant online services and is well equipped with online network services, will trust the online service provider and perceive less risk and experience more activities such as continuous usage and purchase. Thus, how to promote continued online service usage or, alternatively, how to prevent discontinuance is a critical issue for VC service providers to consider. By aggregating a wide range of information and online environments for customers and providing trust to its members, the service providers of virtual communities help to reduce the perceived risk of continuous usage and purchase. Drill down, online service managers realize that achieving strong and sustained customers who continuously use online service and purchase on it is crucial. Therefore, the research into this online service continuance will identify the relationship between the initial usage and the continuous usage and purchase. The research of continuous usage or post adoption has recently emerged as an important issue in the IS literature. Individuals' information systems(IS) continuous usage decisions are congruent with consumers' repeat purchase decisions. The TAM(Technology Acceptance Model) paradigm has been strongly confirmed across a wide range from product purchase on EC to online service usage contexts. The analysis of IS usage based on TAM has proven to be successful across almost online service contexts. However, most of previous studies have focused on only an area (i.e., VC or EC). Just little research has tried to analyze the relationship between VC and EC. The effect of some factors on user intention, captured through several theories such as TAM, has been demonstrated. Yet, few studies have explored the salient relationships of VC users' EC acceptance. To fill this gap between VC and EC research, this paper attempts to develop a research model that extends the TAM perspective in view of the additional contributions of trust in the service provider and trust in members on some factors that affect EC and VC adoption. In this extension, we applied the TAM-to-TAM(T2T) model, and analyzed the transfer effect of trust between these two TAMs. The research model was empirically tested on the context of a social network service. The model was to extend TAM with the trust concept for the virtual community environment from the perspective of tasks. By building an extended model of TAM and examining the relationships between trust and the existing variables of TAM, it is aimed to explain a user's continuous intention to use VC and purchase on EC. The unit of analysis in this paper is an individual user of a virtual community. The population of interest is the individual with the experiences in virtual community. The data for this paper was made available via a Web survey of VC users. In total, 281 cases were gathered for about one week, but there were some missing values in the sample and there were some inappropriate cases. Thus, only 248 cases were finally analyzed. We chose the structural equation analysis to test the hypotheses and it is better suited for explaining complex relationships than the other methods. In this test, AMOS was used to test the Structural Equation Model (SEM). Noticeable results have been found in the T2T model regarding the factors affecting the intention to use of virtual community and loyalty. Our result showed that trust transfer plays a key role in forming the two adoption beliefs. Overall, this study preliminarily confirms the salience of trust transfer in online service.